BackgroundPolicy and decision-making processes are routinely challenged by the complex and dynamic nature of environmental health problems. System dynamics modelling has demonstrated considerable value across a number of different fields to help decision-makers understand and predict the dynamic behaviour of complex systems in support the development of effective policy actions. In this scoping review we investigate if, and in what contexts, system dynamics modelling is being used to inform policy or decision-making processes related to environmental health.MethodsFour electronic databases and the grey literature were systematically searched to identify studies that intersect the areas environmental health, system dynamics modelling, and decision-making. Studies identified in the initial screening were further screened for their contextual, methodological and application-related relevancy. Studies deemed ‘relevant’ or ‘highly relevant’ according to all three criteria were included in this review. Key themes related to the rationale, impact and limitation of using system dynamics in the context of environmental health decision-making and policy were analysed.ResultsWe identified a limited number of relevant studies (n = 15), two-thirds of which were conducted between 2011 and 2016. The majority of applications occurred in non-health related sectors (n = 9) including transportation, public utilities, water, housing, food, agriculture, and urban and regional planning. Applications were primarily targeted at micro-level (local, community or grassroots) decision-making processes (n = 9), with macro-level (national or international) decision-making to a lesser degree. There was significant heterogeneity in the stated rationales for using system dynamics and the intended impact of the system dynamics model on decision-making processes. A series of user-related, technical and application-related limitations and challenges were identified. None of the reported limitations or challenges appeared unique to the application of system dynamics within the context of environmental health problems, but rather to the use of system dynamics in general.ConclusionsThis review reveals that while system dynamics modelling is increasingly being used to inform decision-making related to environmental health, applications are currently limited. Greater application of system dynamics within this context is needed before its benefits and limitations can be fully understood.

• We assessed the potential contribution of the COVIDSafe contact tracing app to the sustained control of COVID-19 following successful suppression of the pandemic in Australia during March-May 2020 • If a high level of community uptake can be achieved, the COVIDSafe app, combined with testing and social distancing, could have a valuable mitigating effect on a new wave of COVID-19 through enhanced and expedited case detection

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It is widely recognised that environmental health services and interventions operate in dynamically complex systems. Environmental health researchers and practitioners work to solve complex problems yet continue to favour methods that eschew the concept of complexity. Conventional quantitative risk assessment methods used in environmental health, while valuable, are often based on studies that examine the effects of individual environmental hazards in isolation. They do not examine a system that leads to adverse environmental health outcomes, such as disease outbreaks. In this research, I explored the applicability of participatory system dynamic modelling as a means of assisting environmental health decision-makers in the management of dynamically complex infectious diseases. Using cryptosporidiosis in South East Queensland as a case study, I applied system dynamic modelling techniques to explore the population-level drivers of Cryptosporidium transmission in the study area, with a particular focus on the role of public aquatic facilities (i.e. public swimming pools). This research was conducted in three stages. This first involved an extensive review of the literature on complexity and environmental health service delivery, decision-making for complex environmental health problems, and system dynamic modelling. This review highlighted current challenges environmental health decision-makers face when developing policies and interventions and identified ways in which system dynamic models can assist in overcoming some of these.

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